A wearable artificial kidney: technical requirements and potential solutions

Kim, Jeong Chul; Garzotto, Francesco; Nalesso, Federico; Cruz, Dinna N.; Kim, Ji Hyun; Kang, Eungtaek; Kim, Hee Chan; Ronco, Claudio

doi:10.1586/erd.11.33

Cited by 33 publications

(20 citation statements)

References 73 publications

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“…Even though technical breakthrough and advantages, several problems should be considered [7,16] (Table 1). First, will it be convenient all day long, especially during sleeping time?…”

Section: Discussionmentioning

confidence: 99%

“…It is easy to anticipate the beneficial effect of more frequent and longer dialysis sessions on the improvement of cardiovascular risk factors and short-term outcomes [5,6], even though it is rarely possible in real clinical situation. To overcome shortcomings of today's dialysis system via technical breakthroughs, wearable dialysis devices have been developed and presented [7,8]. Theoretically, wearable dialysis devices should function without cessation similar to native human kidney but, all of them show strengths and weaknesses [1] ( Table 1).…”

Section: Wearable Dialysis Systemmentioning

confidence: 99%

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Current status of bioartificial kidney

Shin¹

2014

JBiSE

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Current dialysis systems are not perfect considering the low efficacy and cumbersome process of actual practice. To overcome these shortcomings, bioartificial kidneys using renal tubule cells and wearable dialysis are promising ESRD treatments available in the near future. Toward clinical application, however, there are so many obstacles for commercial use of them. In this review, current status of bioartificial kidneys such as the renal tubule cell assist device (RAD) and wearable dialysis devices is presented with the comparison to show the advantages and disadvantages.

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“…Even though technical breakthrough and advantages, several problems should be considered [7,16] (Table 1). First, will it be convenient all day long, especially during sleeping time?…”

Section: Discussionmentioning

confidence: 99%

Section: Wearable Dialysis Systemmentioning

confidence: 99%

Current status of bioartificial kidney

Shin¹

2014

JBiSE

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“…The conceptualization of WAK has been studied during the last decades, with different attempts in order to practically achieve this idea [6]. …”

Section: The Wak: What It Is and Its Purposesmentioning

confidence: 99%

“…It also has to be highly efficient since it should operate like a real kidney, primarily allowing the necessary filtration rate as well as the maintenance of the acid-base balance and of the hydro-electrolytic equilibrium [6]. Recently, new approaches for miniaturization and transportability of medical devices have been developed, paving the way for wearability and the possibility of implantation for renal replacement therapies [7].…”

Section: The Wak: What It Is and Its Purposesmentioning

confidence: 99%

Wak Engineering Evolution

Armignacco

Garzotto²,

Neri³

et al. 2015

Blood Purif

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The wearable artificial kidney (WAK) is a device that allows prolonged and frequent dialysis treatments for patients with end stage renal disease. It potentially provides a practical and feasible solution to satisfy the need for an optimal delivered dialysis. Until now, the WAK has already been presented in several models, proposing different therapeutic modalities and engineering approaches. The ideal solution of a WAK may come from a combination of all the prototypes developed and/or those currently in development. Consequently, it is important to have a complete overview and a deep knowledge of the possible engineering solutions in order to achieve the incremental steps necessary to solve the remaining issues of wearable extracorporeal blood purification devices. Since technical advances are continuously evolving and it is important to focus on clinical requirements and needs, a multidisciplinary collaboration has to be coordinated to achieve the final objective of the practical realization of a wearable artificial kidney. In such a context, the main aim of this article was to analyze more in detail the WAK Engineeristic Development.

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“…A wearable ultrafiltration device should facilitate prolonged frequent treatment at a low blood flow rate (<100 ml/min) for more than 12 h during the patient’s daily activities. To be wearable, a hemofiltration unit should be simple and a blood pump control system should be combined with a hemofilter [9]. However, a lower blood flow rate increases membrane contact time, which accelerates blood-membrane interaction; consequently, membrane fouling or cake layers can develop on the surface of the dialysis membrane over long treatment times [10].…”

Section: Introductionmentioning

confidence: 99%

Hydrodynamic Analysis of the Miniaturized Hemofilter for a Wearable Ultrafiltration Device

et al. 2013

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Background/Aims: Using a small wearable hemofiltration device, heart failure (HF) patients may have the possibility of eliminating acute hemodynamic changes and the freedom from spending many hours attached to a large stationary treatment system. Methods: We developed a miniaturized hemofilter for a vest-type wearable ultrafiltration device for the treatment of overhydration and congestive HF. In this study, we investigated the feasibility of the newly developed hemofilter based on dynamic CT imaging and in vitro evaluation of hydrodynamic properties. Results: The dynamic CT imaging technique showed development of uniform flow distribution and effective bubble removal in the hemofilter. Hydrodynamic performance of the hemofilter was also acceptable with a stable pressure drop in the blood compartment and ultrafiltration profiles in the intended operating ranges for the treatment of congestive HF patients. Conclusions: The newly developed miniaturized hemofilter for a wearable ultrafiltration device meets the technical requirements of wearable medical devices and its structural design enables uniform blood flow distribution and stable hydrodynamics during operation.

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A wearable artificial kidney: technical requirements and potential solutions

Cited by 33 publications

References 73 publications

Current status of bioartificial kidney

Current status of bioartificial kidney

Wak Engineering Evolution

Hydrodynamic Analysis of the Miniaturized Hemofilter for a Wearable Ultrafiltration Device

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